What is the best way to manage dry skin in a 1-week-old newborn?

From the Guidelines

To manage dry skin in a 1-week-old newborn, use gentle, fragrance-free moisturizers specifically formulated for babies after bathing while the skin is still slightly damp. When it comes to managing dry skin in newborns, it's essential to prioritize their delicate skin. According to the British Journal of Dermatology study 1, preventative care for handling and interventions is crucial. Although the study focuses on neonatal epidermolysis bullosa, its recommendations on gentle handling and minimizing friction can be applied to managing dry skin in newborns.

• Limit baths to 5-10 minutes every 2-3 days using lukewarm water and mild, soap-free cleansers.
• Apply moisturizer at least twice daily, focusing on dry areas. Petroleum jelly (Vaseline) or emollients like Aquaphor, CeraVe Baby, or Eucerin Baby are excellent choices.
• Dress your baby in soft, breathable cotton clothing and maintain moderate humidity in your home (40-60%) using a cool-mist humidifier if needed.
• Avoid harsh soaps, bubble baths, and adult skincare products. Newborn skin is naturally dry and peeling in the first few weeks as they adjust to the outside environment after being in amniotic fluid. This dryness is typically temporary and resolves on its own, but proper moisturizing helps maintain the skin barrier. If you notice redness, inflammation, cracking, bleeding, or if dry patches appear yellow or seem to cause discomfort, consult your pediatrician as this could indicate a condition requiring medical attention.

From the Research

Managing Dry Skin in Newborns

• Dry skin in newborns, also known as xerosis, is a common condition that can be managed with proper skincare [(2,3)].
• Gentle cleansers and moisturizers containing barrier lipids can help maintain the protective skin barrier and reduce inflammation 2.
• For newborns, it is recommended to use non-alkaline cleansers and ceramides containing moisturizers to reduce inflammation and maintain a healthy skin barrier function 2.

Skincare Recommendations for Newborns

• Delaying the first newborn bath for 12-24 hours of life can offer benefits of increased parental bonding and breastfeeding success 3.
• Swaddled bathing every 4 days is an effective bathing strategy for premature neonates 3.
• Regular application of bland skin moisturizers can reduce the risk of developing atopic dermatitis in infants with a family history of the condition 3.

Emollient Therapy for Dry Skin

• Topical emollients are the mainstay of basic therapy for managing xerosis cutis (dry skin) [(4,5,6)].
• Lipid-rich ointments are indicated for very dry skin, while hydrophilic creams and lotions are suitable for less severe xerosis cutis 4.
• Frequent and liberal application of emollients is generally recommended, with the optimal quantity and frequency depending on the extent and severity of skin dryness 4.

Best Practices for Emollient Use

• Treatment decisions should be guided by factors such as cosmetic acceptability and practicality to ensure patient adherence to long-term emollient therapy 4.
• Strategies to promote shared decision-making and improve treatment adherence include patient education, allowing patients to trial a range of emollient products, and regularly following-up with patients 4.
• Emollient therapy is a cost-effective strategy to manage patients with chronic dry skin conditions, and access to basic, lower-cost formulations is important to minimize the financial burden on patients 4.